Head and neck squamous cell carcinoma (HNSCC) accounts for almost 90% of cancers involving the upper aerodigestive tract (UADT). In the United States in 2005, cancers of the oral cavity, pharynx and larynx are expected to account for nearly 3% of incident cancers and 2% of cancer deaths. There are approximately 500,000 new cases diagnosed world-wide each year. Men are affected over two times more than women. Over half of these cancers involve the oral cavity. The rest are divided equally between larynx and pharynx.
There is no effective early detection program for head and neck squamous cell carcinoma (HNSCC). A recent study from India shows a survival advantage for screening by oral cavity exam. However sensitivity and specificity of this method are only 75%. Screening by physical exam is expensive, skill-dependent, and cannot detect occult disease. Poor detection practices likely contribute to the poor survival noted in black males and patients from low SES. Access to skilled practitioners may pose a challenge to individuals with limited material resources.
Five-year survival rates for HNSCC are low and have not improved in several decades. Moreover, patients with this disease experience severe morbidity including disfigurement, speech, swallowing and breathing problems. Late stage of diagnosis and propensity to recur are challenges that thwart efforts to improve outcomes in these patients. These challenges are more pronounced in black patients compared to white patients and economically disadvantaged populations compared to wealthy populations. Effective early detection programs that are targeted to high-risk populations may result in diagnosis of a higher proportion of patients with early stage disease and therefore better outcomes.
There is thus an urgent need in the art to develop tests for the early diagnosis of these types of tumors.